بررسی شیوع آنفارکتوس میوکارد خاموش و عوامل مرتبط با آن

ABSTRACT To clarify the prevalence and associated risk factors of silent transmural myocardial infarction (SMI), we examined a consecutive series of 1390 patients (mean age 56.6 years, male 70.9 percent, female 29.1 percent) with diagnosis of transmural myocardial infarction (MI) by resting ECG (with or without previous history of MI).during a period of six years in a cardiovascular private clinic in Rasht. 417 subjects (30 percent of the total patients didn't have previous history of MI(SMI) The frequecy of SMI in women was significantly higher than men (P<0.001). Mean age of patients with SMI was significantly greater than Non-Silent myocardial infarction (NSMI) in total patients (P<0.01) and male patients (P<0.01),but non-significant (NS)in female patients. The frequency of high blood pressure (HBP) in SMI was significantly higher than NSMI (P<0.001) in total patients, and (P<0.001) in men, but NS in women. The frequency of diabetes mellitus (DM) with HBP (P<0.005), Inferior (Posterior)wall MI (P<0.005). anteroseptal MI (P<0.01 atrial fibrillation (AF)(P<0.005), and mean high density lipoprotein (HDL)(P<0.02)in SMI were significantly higher than NSMI. The frequency of cigarette smoking (P<0.001) and mean Serum triglycerides (P<0.05)in SMI was significantly lower than NSMI. The frequency of DM, Stroke, transient ischemic attack, peripheral obstructive arterial disease, family history of coronary artery disease in first degree relatives, blood groups of ABO system, congestive heart failure, mean total cholesterol and low density lipoprotein were different in both groups. We conclude that ,SMI is common and is more in females than males. It was frequent in male patients with older age and HBP with higher HDL, and Lower triglycerides, smaller-Sized infarcts and frequent AF than similar patients with clinically recognized MI.